title: Carbapenem-resistant Acinetobacter ventilator-associated pneumonia: Clinical characteristics and outcome.
abstract: OBJECTIVE
  To study the clinical characteristics and 28-days mortality in patients with ventilator-associated pneumonia (VAP) due to carbapenem-resistant Acinetobacter (CRA).
  
  
  METHODS
  Retrospective, observational, cohort study.
  
  
  METHODS
  Intensive care unit (ICU) of a university hospital.
  
  
  METHODS
  Microbiologically confirmed VAP due to CRA infection.
  
  
  METHODS
  None.
  
  
  RESULTS
  Out of 87 patients with VAP due to CRA, 60 (69%) were male; whose median age was 51 years; 73 (84%) patients were medical; 26 (30%) had history of hospitalization in last 3 months; median acute physiology and chronic health evaluation (APACHE) II was 15 and median SOFA 9 at admission; primary reason for ICU admission was respiratory failure (34%); 46 (53%) patients had more than 2 organ failure at ICU admission; median length of ICU stay was 19 days; 66 (76%) patients need vasoactive agents during ICU stay, whereas 55 (63%) patients had renal failure; median duration of mechanical ventilation was 17 days; 22 (25%) patients had acute respiratory distress syndrome (ARDS) during ICU stay; 72 (83%) patients had exposure to carbapenem before inclusion in the study; 33 (38%) patients had same organism at other sites. In the follow-up, 47 (54%) patient survived at 28 days after having VAP; whereas only 40 (46%) patients were discharged from the hospital.
  
  
  CONCLUSIONS
  CRA-VAP has high crude mortality. Advanced age; severity of illness and presence of pneumonia at ICU admission; and presence of shock, ARDS and renal failure have impact on outcome in these patients.
authors.affiliation: Department of Critical Care Medicine, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
authors.forename: Mohan
authors.initials: M
authors.lastname: Gurjar
authors.forename: Saurabh
authors.initials: S
authors.lastname: Saigal
authors.forename: Arvind Kumar
authors.initials: AK
authors.lastname: Baronia
authors.forename: Bhaskar P
authors.initials: BP
authors.lastname: Rao
authors.forename: Afzal
authors.initials: A
authors.lastname: Azim
authors.forename: Banani
authors.initials: B
authors.lastname: Poddar
authors.forename: Ratender Kumar
authors.initials: RK
authors.lastname: Singh
keywords: Acinetobacter; carbapenem; intensive care unit; ventilator-associated pneumonia